MedChi Spring House of Delegates Recap | |
On Sunday, April 26, MedChi, The Maryland State Medical Society, hosted its 2026 Spring House of Delegate Meeting, held virtually.
This event featured a Legislative Panel session where attendees had the pleasure of hearing from our special guests State Senator Clarence Lam, M.D. and Delegate Terri Hill, M.D.
Here are just a few highlights from Sunday's meeting:
-
Overview of MedChi's Legislative Priorities- The panel highlighted the successful efforts to maintain Medicaid rates at 99% of Medicare rates, defeat harmful tort reform proposals, and pass public health measures including the Vax Act. The panel also discussed recent insurance reforms and the passing of credentialing improvements.
-
Current Healthcare Challenges in Maryland- Senator Lam and Delegate Hill discussed the impact of budget constraints, including new federal requirements for Medicaid redeterminations and work requirements for beneficiaries, which could further reduce healthcare access.
-
AI in Healthcare Implementation Discussion- Delegate Hill and Senator Lam discussed the need to balance embracing AI's efficiency, while also protecting against its exploitative aspects, particularly in areas like downcoding and behavioral health.
The Spring House of Delegates is one of the best ways to partake in Maryland's current healthcare advocacy efforts. Thank you to all who attended and continue to make an impact.
Gene M. Ransom III
CEO
MedChi, The Maryland State Medical Society
| | | |
|
Maryland Fines Cigna, Bans Automatic Downcoding in New MIA Bulletin
In August of 2025, Cigna Health & Life Insurance Company (Cigna) announced it would implement a new automatic downcoding policy. The process of downcoding involves a carrier modifying service codes on claims submitted by health care providers to lower-level, lower-paying codes. MedChi immediately contacted the Maryland Insurance Administration to raise concerns and had legislation introduced (SB797/HB1153) to address the issue.
Following an investigation, on March 13, 2026, the Maryland Insurance Administration fined Cigna $80k for downcoding Evaluation and Management (“E/M”) Codes. Subsequently, on April 7th, the MIA issued Bulletin 26-9: Prompt Payment of Claims – Downcoding Practices Prohibited. These two actions negated the need for the legislation and affirmed that downcoding is prohibited in Maryland.
As stated in the bulletin, under Maryland law, a carrier, within 30 days after receipt of a claim, must:
- Pay the amount of the claim, or
- Send notice that reimbursement is being denied or partially denied, include the reasoning for the denial or partial denial, and request information needed in order for full reimbursement to be made on the submitted claim.
A carrier may not proactively modify a service code on its own assessment and send payment for a lower code, placing the burden on the provider or other person entitled to reimbursement to resubmit the initial claim and higher billing code.
If you believe that you have been subject to downcoding, you may file a complaint directly with the Maryland Insurance Administration. NOTE: While the portal refers to consumers, it is also the provider portal.
| | |
Written Comment Request:
Draft Ozempic Cost Review Study Report (Posted 4/22/2026)
In accordance with COMAR 14.01.04.05F(3), the Maryland Prescription Drug Affordability Board (PDAB) has posted the draft Ozempic Cost Review Study Report and is hereby requesting public written comment. Comments may be submitted in accordance with COMAR 14.01.01.05B(4) by close of business, Friday, May 1, 2026, to comments.pdab@maryland.gov . Information can be found on the PDAB website here.
Written Comment Request: Ozempic: Calculations and Analyses Underpinning Potential UPL Values (Posted: 4/22/2026)
PDAB staff has posted a proposed version of Ozempic: Calculations and Analyses Underpinning Potential UPL Value. Written public comments are requested. Comments may be submitted in accordance with COMAR 14.01.01.05B(4) by close of business, Friday, May 1, 2026, to comments.pdab@maryland.gov . Information can be found on the PDAB website here.
Draft Proposed Regulations for Comment (Posted: 4/22/2026)
The PDAB is soliciting comments on draft UPL regulations for Ozempic under COMAR 14.0101.05B(4). Please submit written comments to pdab.regs@maryland.gov by Friday, May 1, 2026 on the draft regulations listed below:
- Draft COMAR 14.01.07.02- Upper Payment Limit for Ozempic
Information can be found on the PDAB website here.
| | |
MedChi Member Addresses Insurance Delays in Frederick News Post Op Ed
MedChi Member Julio J. Menocal addresses the cost of insurance delays in The Frederick News-Post. Click here to read more.
| | | | |
Former MedChi President Receives President's Award for Leadership in Advancing AI Education in Medicine
MedChi, The Maryland State Medical Society's Immediate Past-President, Dr. Padmini Ranasinghe, was honored for her leadership in helping physicians navigate the rapidly evolving intersection of healthcare and technology with a Presidents Award. Congrats, Dr. Ranasinghe!
Click here for more!
| | | |
If you have news to share about yourself, a colleague, or your practice, and would like us to feature it in MedChi News,
please contact Olivia Ballmann. All submissions are subject to review and approval.
Submission does not guarantee inclusion, publication, or use.
| | | | |
Possible Class Action Settlement if You Accepted Discover Credit Cards
If you accepted or processed Discover credit cards between 2007-2023 you may be eligible to receive payment from a class action settlement. Click here to learn more & complete the initial form to participate.
| | | | | |
Caring One Provides 24/7 Contact Center Coverage for Private Practices
Caring One delivers healthcare contact center and information services that enable hospitals, MCOs, TPAs, and healthcare providers to manage patient communications, treatment plans, and case information efficiently and effectively. Click here for more information.
| | | Thank you for your support! | | Your Advocate. Your Resource. Your Profession. | | |
|
MedChi, The Maryland State Medical Society
800.492.1056 • www.medchi.org
| | | | | |
